Inferior turbinate arterial supply: histologic analysis and clinical implications

Abstract

Objective: To study the arterial architecture of the normal inferior turbinate.

Design: A prospective, nonrandomized, histologic study.

Main outcome measures: Fourteen samples were removed at autopsy and during septoplasty operations, processed in the usual manner, stained with hematoxylin-eosin, and investigated microscopically. The analysis included data on the number, location within or outside the bone, the mean area, wall thickness, and distance the arteries traverse from the point of entrance into the bone to the point of exit into the soft tissue.

Results: One to three arteries enter the inferior turbinate posteriorly. In 7 of 14 inferior turbinates (50%), the arteries lie within the bone and in 2 (14%) within the soft tissue, and in 5 (36%), a mixed pattern was observed. The arteries run along a mean of 1.2 +/- 0.49 cm before piercing the bone into the soft tissue and split off to one to six branches. The mean area and the mean wall thickness of the arteries at the entrance into the bone posteriorly were significantly greater than that of the arteries emerging from the bone and entering the soft tissue anteriorly (0.099 +/- 0.056 mm2 vs 0.051 +/- 0.022 mm2 [p < .01] and 0.116 +/- 0.042 mm vs 0.083 +/- 0.031 mm [p < .05], respectively). The inferior mucosal layer lacks major arteries.

Conclusion: Given the data presented here, the excision of the inferior mucosal layer and the anterior portion of the inferior turbinate bone distal to the point of arterial exit constitute a relatively low risk for postoperative arterial bleeding.